"When the artist is alive in any person, he becomes an inventive, searching, daring, self-impressive creature. Where others close the book he opens it and shows that there are still more pages to see..." Robert Henry
Very few books change the world. Not very many even try. Paul Gruchow’s Letters to a Young Madman has that potential and that ambition in taking on the issue of how the mentally ill are treated by mental health professionals and the culture at large. Based on a manuscript that Gruchow left behind when he died in 2004, the book encountered years of obstacles and delays before finally being published in 2012 by Levins Publishing thanks to the relentless efforts of Gruchow’s literary executor and friend Louis Martinelli. Letters is a book that deserves a wider audience for its eloquent and profound thesis: that the mentally ill should be seen as fully human. (If you believe that they already are, you need to read the book.)
The wider audience that the book deserves would include anyone suffering major depression or other debilitating mental illness, as well as people who work in the field of mental health. The 2012 national year-end booklists, however, made no mention of the book, perhaps because Levins Publishing is a small, low profile regional press. The book was nominated for a Minnesota Book Award but has not received much attention outside Gruchow’s home state. Another factor besides coming from a small publisher is undoubtedly the perception that Letters must be a depressing book. Readers are, quite understandably, reluctant to pick up a book seen as being about depression, suicide, and loss of hope.
That perception is incorrect. In spite of the dark moments and insights the book describes and in spite of Gruchow’s death by prescription drug overdose, Letters is ultimately a work of hope—hope that something good might come out of describing the crushing reality of major depression, that it might help others deal with the life-altering reality of mental illness. Gruchow describes the darkness that comes from depression, but he repeatedly finds some light in that darkness. Late in the book, after recounting years of living with thoughts of suicide and various treatments for his depression including Electroconvulsive Therapy, prescription medications, psychotherapy, and Dialectical Behavior Therapy, he takes a restoring walk through pine trees near Duluth. Suddenly we hear the voice of the younger Gruchow among his “friends”: “White and purple astors bloomed, jewelweeds sparkled, goldenrods turned every sunny nook brilliant yellow. The blue fruits of the bluebeard lilies vied with the scarlet hips of the wild roses for attention” (204). His depression briefly relents, and he tells us that “the feeling of vitality lingered for two days” (204). Even when it fades, he holds on to hope: “The darkness, as it does, closed in again, but I had the conviction this time that, if I could just get there, I knew where to go to find the light” (204). He never gives up on the belief that some path to recovery is possible.
There is, of course, no happy ending. Gruchow himself makes a point of establishing from the start that this will be truthful book about a difficult and serious subject and therefore will not be “a good read” or “amusing” (1). He makes it clear that this won’t be like a visit to Lake Wobegon. Many passages in the book are emotionally wrenching—from his accounts of losing all sense of autonomy when he is hospitalized, to his contemplation of suicide, to his vivid account of lying on a gurney, awaiting Electroconvulsive Therapy. Other passages simply paint a picture of what it’s like to suffer major depression: “I once sat at my desk for three straight days, intent upon stamping an envelope” (19). There is also no one simple message. He faults others for dismissing and ignoring the mentally ill—for building psychiatric wards that do not consider their needs at all, for pushing treatments that may have devastating side effects— but he also finds fault with himself: “My biggest mistake was in allowing myself to be called disabled. When I did so, I became, in my own mind, disabled. And once that happened, I was disabled” (55).
What good might come from describing the reality of serious mental illness? The book provides an answer: we could learn that the mentally ill are still people; that they may be capable of thinking about their own condition; and that any real cure has to involve an internal process, not just an external medical intervention. We could learn that clinical depression and other serious mental illnesses take us into deep water, places where most of us do not like to swim. But if you are in the ocean, you might welcome some advice and some companionship. Letters to a Young Madman, against all expectations, might be your lifeline, and just might change the world.
LETTER TO THE WORLD: PAUL GRUCHOW'S LETTERS TO A YOUNG MADMAN
by: Louis Martinelli
We say that one gets cancer, or a cold, or kidney disease. One would
never think to say that one is cancer. But we say that one is depressed,
or bipolar, or schizophrenic. A disease of the body is a condition. But
a disease of the mind, we think, is a state of being. We no longer
believe, as we did 250 years ago, that the mentally ill are animals,
but we are not yet ready to grant that they are fully human either.
In a voice remarkably clear, eloquent and calm, Paul Gruchow – author of
LETTERS TO A YOUNG MADMAN – explores a double injury inflicted on the mentally ill: The
illness itself, with its often debilitating symptoms, and the more insidious injury made by society,
stigmatization. There is little evidence that the medicalization of what was once called “madness” –
a term Gruchow uses repeatedly in this eliptical memoir – has destigmatized the nearly 300
afflictions now classified as mental disorders in the latest version of the Diagnostic And Statistical
Manual – the bible of the mental health treatment profession.
While Gruchow does not consider this expanding diagnostic umbrella to be an argument
against treatment, his account of his own experience with certain aspects of the treatment system
at the turn of the 21st century – he committed suicide at age 56, in 2004 – is sobering. In several
detailed, Kafquesque depictions of life in a mental hospital, infantilization of patients is the
norm in everything from baby shampoo to toys. The one notable exception to this pattern
of learned helplessness are daily routines so boring, in the age of Piaget and Montessori, we would no
longer subject an infant to them. Television, children's games, crafts, coloring books, and just sitting
alone or with other patients, hour after hour, seems to reinforce the popular stereotype of those
suffering from mental illness as incapable of higher levels of thinking, creativity, self-initiative, or
feeling. The hospital environment proved to be, predictably, non-therapeutic for Gruchow, boredom
increasing depression: His genius level IQ, tested a few years before his death, was 187.
Gruchow cites David L. Rosenhan's classic study, BEING SANE IN INSANE PLACES, which
followed a group of professional researchers after their admittance to a mental hospital, concluding
that no one on the hospital staff could tell the difference between the presumably sane professionals
and the patients diagnosed with mental illness. This role reversal might be comical – as is the movie
WHAT ABOUT BOB in which a patient suffering from multiple phobias disrupts the life and work
of a narcissistic psycho-therapist – were it not for the unsettling questions it raises about the reliability
of psychiatric diagnosis and about the nature of mental illness itself. If diagnosis and treatment are as
much art as science, the difference between the sane and insane members of any group might best be
understood as a continuum rather than a fixed point. If that is the case, LETTERS TO A YOUNG
MADMAN could be read as one person's journey through a continuum of good and bad days, of
happiness and sadness, of remembering and forgetting, of grieving and being unable to grieve, of
moments in which illness defines the journey and of moments in which telling the story becomes a way
to defy illness, leaving behind a map for others to follow.
LETTERS could not be more timely. The World Health Organization has named depression
the leading health crisis in the world, its impact becoming deeper and more widespread.
Wondering, as I have, who the “young madman” might be to whom these letters are addressed, a friend
familiar with Gruchow's story suggested they were written by the author to his younger self, when he
was experiencing his illness as a shameful secret, afraid of being found out. In breaking a silence he
calls “the cornerstone of evil” Gruchow becomes a modern Job, giving voice to all those who suffer
from not only mental illness, but whatever affliction tries the soul.
LETTER FROM THE DIRECTOR
Welcome to the Paul Gruchow Foundation Web-site!
Incorporated in Minnesota in February, 2007 as a tax exempt charitable organization, our mission is to help increase appreciation for Minnesota author Paul Gruchow’s writing and to foster awareness of the relationship between nature, creativity, community and mental health -- themes that are important in Paul’s life and work. Our goals are to encourage dialogue about creating sustainable natural and human communities, to be advocates for mentally ill and other marginalized persons, and to explore the role creativity and imagination play in mental health. A Paul Gruchow center, library, newsletter, annual retreat, and community based Artist In Residence program are projects for which we are currently seeking funding and other support. Your contributions and personal involvement are critical to making these dreams a reality.
This web-site will support our mission by making literary work by and about Paul Gruchow available to a wider readership, by providing information about Paul Gruchow and his legacy, and by providing information about the evolving work of the foundation bearing his name.